HFNL Class notes

Question 1

Facial muscle function symmetrical bilaterally

Answer 1

Facial structures—symmetric
Eyebrows, eyes, ears, nose, mouth appear the same
CN VII (facial nerve)

Question 2

Three (3) pairs of salivary glands

Answer 2

• Parotid gland—in the cheeks over the mandible
• Submandibular glands—beneath the mandible at the angle of the jaw
• Sublingual glands—lie in the floor of the mouth

Question 3

Temporal artery

Answer 3

superior to the temporalis muscle; pulse anterior to the ear

Question 4

Vessels in neck

Answer 4

Common carotid artery
External carotid artery
Internal carotid artery
Internal jugular vein
External jugular vein

Question 5

Major neck muscles

Answer 5

Sternomastoid—allows head rotation, flexion
Trapezius—allows shoulder movement, extension and turning of the head

CN XI (spinal accessory nerve)

Question 6

Thyroid gland & cartilages (2)

Answer 6

Straddles the trachea
Has 2 lobes
Synthesizes and secretes thyroid hormones
Highly vascular
Upper tracheal ring—cricoid cartilage
Thyroid cartilage—is just above the cricoid—also known as Adam’s Apple

Question 7

Lymphadenopathy

Answer 7

Increased size of lymph nodes ( > 1 cm)
Indicates infection, allergy, or neoplasm

Check areas enlarged nodes drain for the source of a problem

Eventually all head and neck structures drain into the deep cervical chain

Question 8

Developmental Competence: Infants head size and fontanels

Answer 8

Infants: fontanels close within first 2 years (anterior fontanel)
Head size greater than chest circumference at birth

Question 9

Developmental Competence: Adolescents

Answer 9

enlargement of thyroid cartilage—voice deepens

Question 10

Developmental Competence: Aging Adult facial bones and orbits

Answer 10

facial bones and orbits appear more prominent

Question 11

Subjective data: headaches and associated factors/sx

Answer 11

caution if client has severe headache without history of headaches

PQRSTU

N/V; visual changes; fever

Question 12

Subjective data: head injury and associated factors

Answer 12

Get the story
PQRSTU

Associated factors/symptoms: neck pain; visual changes; nasal or ear discharge

Question 13

Subjective data: dizziness

Answer 13

PQRSTU

Ask about food/fluid intake, vomiting, bloody or black stools, occupation, falls

Question 14

Subjective data: neck pain

Answer 14

PQRSTU

Determine hx of injury

Ask about occupation, stress, sleep

Question 15

OD: Head/face

Answer 15

Note- size, shape, symmetry, skin, muscle tone

Assess CN VII

Question 16

OD: Neck

Answer 16

Assess for general swelling
Note range of motion 
Assess carotid pulsation—one side only!
Check for lymph node enlargement
Assess CN XI

Question 17

OD: Trachea

Answer 17

Palpate to establish it is midline

Why would it not be in the midline?

Question 18

Causes of deviated trachea

Answer 18

Aneurysm, tumor, unilateral thyroid enlargement, pneumothorax causes deviation toward unaffected side

Question 19

OD: What to expect with visualization and palpation of the Thyroid gland

Answer 19

Should not be visibly enlarged

Should not be easy to palpate

Question 20

OD: Infants & children fontanels

Answer 20

Anterior fontanel will bulge with crying or lying down

Fontanels will fell firm, concave

Question 21

OD: Infants & children 2 causes of head asymmetry appearance

Answer 21

Caput succedaneum—edematous swelling and ecchymosis of presenting part of head

Cephalhematoma—subperiosteal hematoma, reabsorbed during first few weeks of life

Question 22

Molding

Answer 22

Overriding of cranial bones during birth

Only lasts few days to a week

Question 23

OD: infant & children head control

Answer 23

Infant can turn head side to side by 2 weeks; head controlled achieved by 4 months

Question 24

OD: infants & children lymph system

Answer 24

Child’s lymph nodes more easy to palpate than adult’s

Question 25

What is nuchal rigidity

Answer 25

Rigid neck, can’t touch chin to chest—flexion movements

Associated with meningitis/encephalitis

Question 26

Aging adults: senile tremors

Answer 26

Bengin

Include head nodding, and lounge protrusion

If teeth lost lower face looks smaller w/ mouth sunken in

Question 27

Concussions S/S

Answer 27

Headache or pressure
N/V
photophobia, phonophobia
Change in reaction time, balance, coordination 
Changes in sleep patterns

Question 28

Conclusion s/s onset

Answer 28

Quick or delayed:

Appearance over days
some individuals have persistent s/s

Most individuals have disappearance of s/s w/n 10 days

Question 29

Risk of concussion

Answer 29

Having one concussion raises risk of having another especially in the
1st 10 days